Metronidazole 500mg/100ml Inj,100ml

Metronidazole is a nitroimidazole antimicrobial. It enters bacterial and protozoal cells, where its nitro group is reduced by electron transport proteins to highly reactive nitro radical anions. These reactive intermediates damage DNA and other macromolecules, leading to cell death. This reduction process occurs only in anaerobic or microaerophilic conditions, explaining its selective activity against anaerobes and certain protozoa.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:

Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Redness or white patches in the mouth or throat
Vaginal itching or discharge
Abnormal or rapid heartbeat
Painful urination or blood in the urine
Frequent urination
Pelvic pain
Ringing in the ears, hearing loss, or other changes in hearing
Nervous system problems, including:
+ Burning, numbness, or tingling sensations
+ Changes in balance or vision
+ Dizziness or fainting
+ Headache
+ Insomnia
+ Seizures
+ Speech difficulties
Mood changes, such as:
+ Confusion
+ Depression
+ Irritability
+ Fatigue
+ Weakness
Symptoms of aseptic meningitis, including:
+ Headache
+ Fever
+ Chills
+ Nausea or vomiting
+ Stiff neck
+ Rash
+ Sensitivity to light
+ Drowsiness
+ Confusion
Signs of infection, such as:
+ Fever
+ Chills
+ Sore throat
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other serious reactions, which may affect internal organs
+ Symptoms include:
- Red, swollen, blistered, or peeling skin
- Red or irritated eyes
- Sores in the mouth, throat, nose, eyes, genitals, or skin
- Fever
- Chills
- Body aches
- Shortness of breath
- Swollen glands

Other Possible Side Effects

Most medications can cause side effects, but many people experience none or only mild symptoms. If you notice any of the following side effects, contact your doctor if they bother you or do not resolve on their own:

Gastrointestinal symptoms, such as:
+ Constipation
+ Diarrhea
+ Stomach pain
+ Nausea or vomiting
+ Decreased appetite
Stomach cramps
Metallic taste
Headache
Joint pain
Decreased libido
Irritation at the injection site

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction and its symptoms.
If you have Cockayne syndrome, as some individuals with this condition have experienced liver problems while taking this medication. In some cases, these liver issues have been severe, persistent, or even fatal.
If you have taken disulfiram within the past 14 days.
If you are less than 12 weeks pregnant, as this medication is not intended for use during this period.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine whether it is safe to take this medication in conjunction with your other treatments and health status. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Your doctor will also instruct you to have regular blood tests, so be sure to follow their guidance and discuss any concerns with them.

This medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug. If you are undergoing dialysis, consult with your doctor to discuss any necessary precautions.

To minimize potential interactions, you may need to avoid consuming alcohol or products containing alcohol or propylene glycol during treatment with this medication and for at least 72 hours after your last dose. Examples of products that may contain alcohol or propylene glycol include some cough syrups. Consuming these substances may cause adverse effects such as stomach cramps, nausea, vomiting, headaches, and flushing. Consult with your doctor to determine if you need to avoid alcohol or products containing alcohol or propylene glycol.

Do not take this medication for longer than prescribed, as this may increase the risk of a second infection. If you are following a low-sodium or sodium-free diet, consult with your doctor, as some formulations of this medication may contain sodium.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects. Pregnant or breastfeeding women, or those planning to become pregnant, should discuss the potential benefits and risks of this medication with their doctor to ensure informed decision-making.

• Alcohol (including propylene glycol-containing products) - disulfiram-like reaction
• Disulfiram (within 2 weeks) - psychotic reactions

• Warfarin and other oral anticoagulants (increased anticoagulant effect)
• Lithium (increased lithium levels and toxicity)
• Busulfan (increased busulfan toxicity)
• Phenytoin, Phenobarbital (decreased metronidazole levels, increased phenytoin levels)
• Cimetidine (increased metronidazole levels)

• Fluorouracil (increased fluorouracil toxicity)
• Cyclosporine (increased cyclosporine levels)
• Tacrolimus (increased tacrolimus levels)
• Oral contraceptives (potential for reduced efficacy, though clinical significance debated)

• Cholestyramine (decreased metronidazole absorption if oral formulation used)

• Nausea
• Vomiting
• Diarrhea
• Metallic taste
• Headache
• Dizziness
• Peripheral neuropathy (numbness, tingling, weakness)
• Seizures
• Encephalopathy
• Aseptic meningitis
• Rash
• Darkening of urine

Metronidazole crosses the placenta. While animal studies show some evidence of carcinogenicity, human data from controlled studies and meta-analyses have not shown an increased risk of birth defects or other adverse outcomes when used during the second and third trimesters. Use in the first trimester is generally avoided if possible, but may be considered if clearly needed and benefits outweigh risks.

Metronidazole is excreted into breast milk in concentrations similar to maternal plasma. Due to the potential for serious adverse reactions, including carcinogenicity (based on animal data), in the breastfed infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. If a single high dose is given, breastfeeding can be interrupted for 12-24 hours.

Metronidazole is used in pediatric patients for various anaerobic and protozoal infections. Dosing is weight-based. Neonates and infants may have reduced clearance, requiring careful monitoring and dose adjustment. Safety and efficacy in very low birth weight infants have not been fully established.

No specific dose adjustment is generally required based solely on age. However, elderly patients are more likely to have decreased hepatic function, which may necessitate dose reduction in severe impairment. Monitor for adverse effects, especially neurological ones, as elderly patients may be more susceptible.

• Metronidazole is a potent anaerobic and antiprotozoal agent, but it has no activity against aerobic bacteria.
• The disulfiram-like reaction with alcohol is severe and patients must be counselled rigorously to avoid all alcohol-containing products during and for at least 3 days after therapy.
• Prolonged or high-dose therapy can lead to peripheral neuropathy or CNS toxicity (e.g., seizures, encephalopathy). Monitor for these symptoms and discontinue if they occur.
• Metronidazole can significantly potentiate the effect of warfarin, requiring frequent INR monitoring and dose adjustments.
• IV metronidazole should be infused slowly over 30-60 minutes to minimize infusion-related reactions.
• Urine discoloration (darkening) is a common and harmless side effect.

• Clindamycin (for anaerobic infections, but less effective against some protozoa)
• Tigecycline (broad-spectrum, including anaerobes)
• Carbapenems (e.g., Imipenem, Meropenem, Ertapenem - broad-spectrum, including anaerobes)
• Tinidazole (another nitroimidazole, similar spectrum, longer half-life)
• Oral Vancomycin or Fidaxomicin (for C. difficile infection, where metronidazole is also used)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist for more information. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide details about the medication taken, the amount, and the time it occurred.